Cardiovascular disease is the leading cause of morbidity, mortality, and costs worldwide. At the same time this chronic disease is largely preventable. Medical science knows how to save most of these lives by removing the major risk factors of smoking, diabetes, and hypertension. And many people are told just what they need to do to reduce these risk factors—stop smoking, reduce sugar intake, eat healthier, reduce alcohol intake, increase cardiovascular exercise, lose weight, and, if needed, take blood-pressure medication. But many people do not follow this good advice. Because of this, millions of people needlessly die from cardiovascular disease.
One reason that people don't follow this good medical advice is because they think they are different, they do not want to change their behaviors that are causing the disease, or they do not know what to change in their particular case. When a physician tells them that they are at risk from heart disease because they are overweight, for example, many people know that this judgment is not necessarily specific to them—it is based on averages and demographics. So being a particular weight may not negatively affect a particular person's heart. Even if they do believe it to be specific to them they often do not know how to lose weight in their particular case. Individuals respond to foods in different ways, for example.
This reason for not following good advice can be addressed by testing each person's heart to see if their heart is healthy. With hard data many would take this advice seriously should their heart show signs of heart disease. Unfortunately, measuring heart health can be expensive and dangerous. A cardiac pressure-volume loop, for example, can be determined by placing a catheter into the left ventricle of a person's heart. While this invasive testing can successfully measure the person's heart health through determining this cardiac pressure-volume loop, doing so results in the death of the person about 1% of the time. It is also expensive and involves significant trauma and stress on the person. Because of this, only persons that already appear to have heart disease are tested this way, which is generally too late to save them.
Another reason that people don't follow this good advice, or don't follow it for long enough to prevent heart disease, is because they do not see the benefit. When people take the advice of changing their diet and habits—which most people do not want to do—they often don't see the improvement. They may see that they have lost weight and perhaps that their blood pressure is lower, but these are not precise measures of heart health. Because of this, many people go back to their old habits only to later die of heart disease.